Lewy Body Dementia
Information on the causes, symptoms, and prognosis of cognitive decline caused by protein deposits in the brain.
Symptoms and causes
Lewy body dementia is the loss of mental functions due to the accumulation of excessive alpha-synuclein protein in the brain, forming deposits known as Lewy bodies. It is one of the most common types of degenerative dementia, after Alzheimer’s disease and vascular dementia.
This neurodegenerative condition develops progressively, manifesting differently at each stage:
- Early stage: Difficulty performing daily activities begins. Mild symptoms may be mistaken for other types of dementia.
- Intermediate stage: Rapid progression occurs, significantly limiting patient autonomy.
- Late stage: The condition worsens considerably, and patients become completely dependent. This stage can last between six months and two years.
Lewy body dementia has no cure, so the prognosis is poor for all patients. Symptoms vary by individual and progress at different rates. Although it can be shorter in some cases, life expectancy is usually between five and eight years from diagnosis.
Symptoms
The most characteristic symptoms at each stage of Lewy body dementia are:
Early stage:
- Memory problems and contamination of memories
- Difficulty concentrating
- Tremors
- Mild hallucinations and delusions
- Sleep disturbances, characteristically REM sleep behavior disorder
Intermediate stage:
- Memory deterioration
- Language impairment: difficulty organizing words to convey a message or using words from another conversation
- Confusion
- Spatial and temporal disorientation
- Daytime sleepiness
- Rigidity
- Balance problems
- Hallucinations:
- Passing: shadows appearing at the edges of the visual field
- Presence: perception of a person nearby
- Structured: clear representation of people, objects, or animals
- Illusions: seeing objects that do not exist or altered features of real objects
Late stage:
- Memory loss
- Muscle rigidity
- Swallowing difficulties
- Paranoia
- Agitation
Causes
The main cause of Lewy body dementia is the formation of alpha-synuclein protein deposits in brain regions that control thought, memory, behavior, and movement. Normally, this protein regulates neuronal functions, such as preventing cell death and neurotransmitter secretion.
Risk Factors
Studies indicate that the risk of developing Lewy body dementia increases in the following cases:
- Age: more common in people over 60 years old
- Family history of dementia or Parkinson’s disease, even though it is not hereditary
- Sex: more common in men than women
Complications
Lewy body dementia progresses with the disease, although it usually does not lead to other pathologies. Over time, complications typically include:
- Complete cognitive decline
- Injuries from falls
- Severe tremors
- Immobility
- Aggressive behaviors
Prevention
Lewy body dementia cannot be prevented. However, specialists recommend the following to reduce the risk of future dementia:
- Maintain a balanced diet
- Keep a healthy weight
- Control hypertension and high blood sugar
- Exercise regularly
- Engage in mentally stimulating activities: crafts, reading, board games, hobbies
- Participate in social activities
- Get sufficient sleep
- Avoid smoking
- Limit alcohol consumption
Which doctor treats Lewy body dementia?
Lewy body dementia is diagnosed in the neurology specialty, with treatment also involving neuropsychology or clinical psychology specialists.
Diagnosis
Lewy body dementia is diagnosed following this protocol:
- Medical history: evaluation of personal and family history, lifestyle, and symptoms
- Neurological examination: assessment of reflexes, balance, strength, muscle tone, and eye movements
- Cognitive assessment: evaluates ability to express thoughts, solve problems, follow numerical sequences, spell words, etc.
- Neuropsychological Evaluation: comprehensive study of cognitive, emotional, and behavioral abilities
- Brain Magnetic Resonance Imaging (MRIBrain Magnetic Resonance Imaging (MRI))Brain Magnetic Resonance Imaging (MRI)) ): performed to rule out other types of dementia or physical diseases such as stroke or tumors
- Positron Emission Tomography (PET) Scan of the Brain: assesses glucose metabolism in the occipital lobe, which is reduced in affected patients
Treatment
Currently, Lewy body dementia has no cure. Treatments focus on alleviating symptoms:
- Cholinesterase inhibitors: increase neurotransmitter levels to enhance memory and cognitive function
- Levodopa: reduces muscle rigidity
- Rehabilitation therapies: personalized interventions typically include:
- Cognitive stimulation to slow mental deterioration
- Occupational therapy to teach alternative ways to perform daily tasks safely
- Music therapy to promote well-being
- Speech therapy to improve pronunciation clarity and treat swallowing difficulties
